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Histoplasma capsulatum infection associated with continuous ambulatory peritoneal dialysis
Abstract:
Fungal infection has become increasingly more important in patients undergoing continuous ambulatory peritoneal dialysis. We report here a case of Histoplasma capsulatum infection in such a Hong Kong Chinese patient who presented with fever and peritonitis. Histoplasma capsulatum was isolated from the dialysis fluid and histoplasma antibody was detected in the serum. The patient responded to the combined treatment of fluconazole, 5-flurocytosine and amphotericin B. This is the first reported case of histoplasmosis in Hong Kong.
Insights
Fungal infections are a growing concern for patients on continuous ambulatory peritoneal dialysis. This case highlights Histoplasma capsulatum peritonitis in Hong Kong, successfully treated with antifungal medications.
Area of Science:
- Mycology
- Infectious Diseases
- Nephrology
Background:
- Fungal infections pose increasing risks for patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Histoplasmosis, a systemic fungal infection, is endemic in certain regions but rarely reported in CAPD patients.
Observation:
- A Hong Kong Chinese patient on CAPD presented with fever and peritonitis, indicative of an infection.
- Diagnostic tests revealed Histoplasma capsulatum in the peritoneal dialysis fluid and elevated histoplasma antibodies in the serum.
Findings:
- The patient was diagnosed with histoplasmosis, specifically presenting as peritonitis.
- Successful treatment was achieved using a combination of fluconazole, 5-flurocytosine, and amphotericin B.
Implications:
- This case represents the first documented instance of histoplasmosis in Hong Kong.
- It underscores the importance of considering uncommon fungal pathogens in CAPD-related peritonitis, especially in endemic areas.
- Early diagnosis and appropriate combination antifungal therapy are crucial for managing such infections in immunocompromised patients.